Triage Drift: A Workplace Study in a Pediatric Emergency Department

This paper presents a workplace study of triage work practices within an emergency department (ED). We examine the practices, procedures, and organization in which ED staff uses tools and technologies when coordinating the essential activity of assessing and sorting patients arriving at the ED. The paper provides in-depth empirical observations describing the situated work practices of triage work, and the complex collaborative nature of the triage process. We identify and conceptualize triage work practices as comprising patient trajectories, triage nurse activities, coordinative artefacts and exception handling; we also articulate how these four features of triage practices constitute and connect workflows, organize and re-organize time and space during the triage process. Finally we conceptualize these connections as an assessing and sorting mechanism in collaborative work. We argue that the complexities involved in this mechanism are a necessary asset of triage work, which calls for a reassessment of the concept of triage drift.     

Improving SCTP retransmission delays for time-dependent thin streams

A large number of network services rely on IP and reliable transport protocols. For applications that provide abundant data for transmission, loss is usually handled satisfactorily, even if the application is latency-sensitive (Wang et al. 2004). For data streams where small packets are sent intermittently, however, applications can occasionally experience extreme latencies (Griwodz and Halvorsen 2006). As it is not uncommon that such thin-stream applications are time-dependent, any unnecessarily induced delay can have severe consequences for the service provided. Massively Multiplayer Online Games (MMOGs) are a defining example of thin streams. Many MMOGs (like World of Warcraft and Age of Conan) use TCP for the benefits of reliability, in-order delivery and NAT/firewall traversal. It has been shown that TCP has several shortcomings with respect to the latency requirements of thin streams because of the way it handles retransmissions (Griwodz and Halvorsen 2006). As such, an alternative to TCP may be SCTP (Stewart et al. 2000), which was originally developed to meet the requirements of signaling transport. In this paper, we evaluate the Linux-kernel SCTP implementation in the context of thin streams. To address the identified latency challenges, we propose sender-side only enhancements that reduce the application-layer latency in a manner that is compatible with unmodified receivers. These enhancements can be switched on by applications and are used only when the system identifies the stream as thin. To evaluate the latency performance, we have performed several tests over various real networks and over an emulated network, varying parameters like RTT, packet loss and amount of competing cross traffic. When comparing our modifications with SCTP on Linux and FreeBSD and TCP New Reno, our results show great latency improvements and indicate the need for a separate handling of thin and thick streams.     

A case study comparing defect profiles of a reused framework and of applications reusing it

The benefits of software reuse have been studied for many years. Several previous studies have observed that reused software has a lower defect density than newly built software. However, few studies have investigated empirically the reasons for this phenomenon. To date, we have only the common sense observation that as software is reused over time, the fixed defects will accumulate and will result in high-quality software. This paper reports on an industrial case study in a large Norwegian Oil and Gas company, involving a reused Java class framework and two applications that use that framework. We analyzed all trouble reports from the use of the framework and the applications according to the Orthogonal Defect Classification (ODC), followed by a qualitative Root Cause Analysis (RCA). The results reveal that the framework has a much lower defect density in total than one application and a slightly higher defect density than the other. In addition, the defect densities of the most severe defects of the reused framework are similar to those of the applications that are reusing it. The results of the ODC and RCA analyses reveal that systematic reuse (i.e. clearly defined and stable requirements, better design, hesitance to change, and solid testing) lead to lower defect densities of the functional-type defects in the reused framework than in applications that are reusing it. However, the different “nature” of the framework and the applications (e.g. interaction with other software, number and complexity of business logic, and functionality of the software) may confound the causal relationship between systematic reuse and the lower defect density of the reused software. Using the results of the study as a basis, we present an improved overall cause–effect model between systematic reuse and lower defect density that will facilitate further studies and implementations of software reuse.

DanNet: the challenge of compiling a wordnet for Danish by reusing a monolingual dictionary

This paper is a contribution to the discussion on compiling computational lexical resources from conventional dictionaries. It describes the theoretical as well as practical problems that are encountered when reusing a conventional dictionary for compiling a lexical-semantic resource in terms of a wordnet. More specifically, it describes the methodological issues of compiling a wordnet for Danish, DanNet, from a monolingual basis, and not—as is often seen—by applying the translational expansion method with Princeton WordNet as the English source. Thus, we apply as our basis a large, corpus-based printed dictionary of modern Danish. Using this approach, we discuss the issues of readjusting inconsistent and/or underspecified hyponymy hierarchies taken from the conventional dictionary, sense distinctions as opposed to the synonym sets of wordnets, generating semantic wordnet relations on the basis of sense definitions, and finally, supplementing missing or implicit information.     

Optimization of friction stir welding using space mapping and manifold mapping—an initial study of thermal aspects

The aim of this paper is to optimize a thermal model of a friction stir welding process by finding optimal welding parameters. The optimization is performed using space mapping and manifold mapping techniques in which a coarse model is used along with the fine model to be optimized. Different coarse models are applied and the results and computation time are compared to gradient based optimization using the full model. It is found that the use of space and manifold mapping reduces the computational cost significantly due to the fact that fewer function evaluations and no fine model gradient information is required.     

Generating relational database transactions from eb 3 attribute definitions

eb ³ is a trace-based formal language created for the specification of information systems. In eb ³, each entity and association attribute is independently defined by a recursive function on the valid traces of external events. This paper describes an algorithm that generates, for each external event, a transaction that updates the value of affected attributes in their relational database representation. The benefits are twofold: eb ³ attribute specifications are automatically translated into executable programs, eliminating system design and implementation steps; the construction of information systems is streamlined, because eb ³ specifications are simpler and shorter to write than corresponding traditional specifications, design and implementations. In particular, the paper shows that simple eb ³ constructs can replace complex SQL queries which are typically difficult to write.

Evaluation of a type 1 diabetes serum cohort by SELDI-TOF MS protein profiling

Proteomics analysis of serum from patients with type 1 diabetes (T1D) may lead to novel biomarkers for prediction of disease and for patient monitoring. However, the serum proteome is highly sensitive to sample processing and before proteomics biomarker research serum cohorts should preferably be examined for potential bias between sample groups. SELDI‐TOF MS protein profiling was used for preliminary evaluation of a biological‐bank with 766 serum samples from 270 patients with T1D, collected at 18 different paediatric centers representing 15 countries in Europe and Japan over 2 years (2000–2002). Samples collected 1 (n = 270), 6 (n = 248), and 12 (n = 248) months after T1D diagnosis were grouped across centers and compared. The serum protein profiles varied with collection site and day of analysis; however, markers of sample processing were not systematically different between samples collected at different times after diagnosis. Three members of the apolipoprotein family increased with time in patient serum collected 1, 6, and 12 months after diagnosis (ANOVA, p<0.001). These results support the use of this serum cohort for further proteomic studies and illustrate the potential of high‐throughput MALDI/SELDI‐TOF MS protein profiling for evaluation of serum cohorts before proteomics biomarker research.     

Wide band resonant ultrasound spectroscopy of spheroidal modes for high accuracy estimation of Poisson coefficient of balls

An original inversion method specifically adapted to the estimation of Poisson coefficient of balls by using their resonance spectra is described. From the study of their elastic vibrations, it is possible to accurately characterize the balls. The proposed methodology can create both spheroidal modes in the balls and detect such vibrations over a large frequency range. Experimentally, by using both an ultrasonic probe for the emission (piezoelectric transducer) and a heterodyne optic probe for the reception (interferometer), it was possible to take spectroscopic measurements of spheroidal vibrations over a large frequency range (100 kHz-45 MHz) in a continuous regime. This method, which uses ratios between wave resonance frequencies, allows the Poisson coefficient to be determined independently of Young's modulus and the ball's radius and density. This has the advantage of providing highly accurate estimations of Poisson coefficient (+/-4.3 x 10(-4)) over a wide frequency range.     

Non-Hierarchical Architected Materials with Extreme Stiffness and Strength

Stretch-dominated truss and plate microstructures are contenders in the quest for realizing architected materials with extreme stiffness and strength. In the low volume fraction limit, closed-cell isotropic plate microstructures meet theoretical upper bounds on stiffness but have low buckling strength, whereas open-cell truss microstructures have high buckling strength at the cost of significantly reduced stiffness. At finite volume fractions, the picture becomes less clear but both are outperformed by hollow truss lattice and hierarchical microstructures in terms of buckling strength. Despite significant advances in manufacturing methods, hollow and multi-scale hierarchical microstructures are still challenging to build. The question is if there exist realizable microstructures providing stiffness and strength matching or even beating hard-to-realize hollow or hierarchical microstructures? Herein, single-scale non-hierarchical (first order) microstructures that beat the buckling strength of hollow truss lattice structures by a factor of 2.4 and first- and second-order plate microstructures by factors of 5 and 1.4, respectively, are systematically designed, built, and tested. Stiffness of the microstructures is within 40% of theoretical bounds and beats both truss and second order plate microstructures. The microstructures are realized with 3D printing. Experiments validate theoretical predictions and additional insight is provided through numerical modeling of a CT-scanned sample.     

Pseudo-T2 mapping for normalization of T2-weighted prostate MRI

Magnetic Resonance Materials in Physics, Biology and Medicine - Signal intensity normalization is necessary to reduce heterogeneity in T2-weighted (T2W) magnetic resonance imaging (MRI) for...